NPI | 1619681889 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101Y00000X Counselor (Licence: NE 13241) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NE 7803) |
Enumeration Date | 2023-01-11 |
Last Update Date | 2023-01-11 |